丙型肝炎病毒(Hepatitis C virus,HCV)是造成慢性肝炎、肝硬化乃至肝癌的主要原因之一,严重威胁人类健康。宿主因素可影响HCV的感染、治疗效果和自然清除率。近期,欧美多个研究组对自愈和经过治疗的慢性丙型肝炎患者进行了全基因组关联...丙型肝炎病毒(Hepatitis C virus,HCV)是造成慢性肝炎、肝硬化乃至肝癌的主要原因之一,严重威胁人类健康。宿主因素可影响HCV的感染、治疗效果和自然清除率。近期,欧美多个研究组对自愈和经过治疗的慢性丙型肝炎患者进行了全基因组关联分析(Genome-wide association study,GWAS),证明IL28B基因(编码IFN-λ3)的单核苷酸多态位点(Single nucleotide polymorphism,SNP)影响HCV患者的治疗效果和自然清除率。IFN-λ3通过与其异源二聚受体IFN-λR1·IL-10R2结合进行信号传导,上调干扰素刺激基因的表达,进而发挥抗病毒、抑制肿瘤细胞生长以及免疫调节等生物学功能,有望成为一种新型抗HCV药物。虽然IL28B基因SNP影响病毒清除的机制尚未清楚,但其关联分析结果可作为HCV患者临床治疗的辅助指导,对HCV患者进行IL28B基因遗传易感和功能研究将有助于该病的预防和治疗。展开更多
AIM: To establish the association between lymph node involvement and the response to neoadjuvant therapy in locally advanced rectal cancer.METHODS: Data of 130 patients with mid and low locally advanced rectal adenoca...AIM: To establish the association between lymph node involvement and the response to neoadjuvant therapy in locally advanced rectal cancer.METHODS: Data of 130 patients with mid and low locally advanced rectal adenocarcinoma treated with neoadjuvant chemoradiation followed by radical surgery over a 5-year period were reviewed. Tumor staging was done by endorectal ultrasound and/or magnetic resonance imaging. Tumor response to neoadjuvant therapy was determined by T-downstaging and tumor regression grading(TRG). Pathologic complete response(p CR) is defined as the absence of tumor cells in the surgical specimen(yp T0N0). The varying degrees TRG were classified according to Mandard's scoring system. The evaluation of the response is based on the comparison between previous clinico-radiological staging and the results of pathological evaluation. χ2 and Spearman's correlation tests were used for the comparison of variables. RESULTS: Pathologic complete response(p CR, yp T0N0, TRG1) was observed in 19 cases(14.6%), and other 18(13.8%) had only very few residual malignant cells in the rectal wall(TRG2). T-downstaging was found in 63(48.5%). Mean lymph node retrieval was 9.4(range0-38). In 37 cases(28.5%) more than 12 nodes were identified in the surgical specimen. Preoperative lymph node involvement was seen in 77 patients(59.2%), 71 N1 and 6 N2. Postoperative lymph node involvement was observed in 41 patients(31.5%), 29 N1 and 12 N2, while the remaining 89 were N0(68.5%). In relation to yp T stage, we found nodal involvement of 9.4% in yp T0-1, 22.2% in yp T2 and 43.7% in yp T3-4. Of the 37 patients considered "responders" to neoadjuvant therapy(TRG1 and 2), there were only 4 N+(10.8%) and the remainder N0(89.2%). In the "non responders" group(TRG 3, 4 and 5), 37 cases were N+(39.8%) and 56(60.2%) were N0(P < 0.001).CONCLUSION: Response to neoadjuvant chemoradiation in rectal cancer is associated with lymph node involvement.展开更多
文摘丙型肝炎病毒(Hepatitis C virus,HCV)是造成慢性肝炎、肝硬化乃至肝癌的主要原因之一,严重威胁人类健康。宿主因素可影响HCV的感染、治疗效果和自然清除率。近期,欧美多个研究组对自愈和经过治疗的慢性丙型肝炎患者进行了全基因组关联分析(Genome-wide association study,GWAS),证明IL28B基因(编码IFN-λ3)的单核苷酸多态位点(Single nucleotide polymorphism,SNP)影响HCV患者的治疗效果和自然清除率。IFN-λ3通过与其异源二聚受体IFN-λR1·IL-10R2结合进行信号传导,上调干扰素刺激基因的表达,进而发挥抗病毒、抑制肿瘤细胞生长以及免疫调节等生物学功能,有望成为一种新型抗HCV药物。虽然IL28B基因SNP影响病毒清除的机制尚未清楚,但其关联分析结果可作为HCV患者临床治疗的辅助指导,对HCV患者进行IL28B基因遗传易感和功能研究将有助于该病的预防和治疗。
文摘AIM: To establish the association between lymph node involvement and the response to neoadjuvant therapy in locally advanced rectal cancer.METHODS: Data of 130 patients with mid and low locally advanced rectal adenocarcinoma treated with neoadjuvant chemoradiation followed by radical surgery over a 5-year period were reviewed. Tumor staging was done by endorectal ultrasound and/or magnetic resonance imaging. Tumor response to neoadjuvant therapy was determined by T-downstaging and tumor regression grading(TRG). Pathologic complete response(p CR) is defined as the absence of tumor cells in the surgical specimen(yp T0N0). The varying degrees TRG were classified according to Mandard's scoring system. The evaluation of the response is based on the comparison between previous clinico-radiological staging and the results of pathological evaluation. χ2 and Spearman's correlation tests were used for the comparison of variables. RESULTS: Pathologic complete response(p CR, yp T0N0, TRG1) was observed in 19 cases(14.6%), and other 18(13.8%) had only very few residual malignant cells in the rectal wall(TRG2). T-downstaging was found in 63(48.5%). Mean lymph node retrieval was 9.4(range0-38). In 37 cases(28.5%) more than 12 nodes were identified in the surgical specimen. Preoperative lymph node involvement was seen in 77 patients(59.2%), 71 N1 and 6 N2. Postoperative lymph node involvement was observed in 41 patients(31.5%), 29 N1 and 12 N2, while the remaining 89 were N0(68.5%). In relation to yp T stage, we found nodal involvement of 9.4% in yp T0-1, 22.2% in yp T2 and 43.7% in yp T3-4. Of the 37 patients considered "responders" to neoadjuvant therapy(TRG1 and 2), there were only 4 N+(10.8%) and the remainder N0(89.2%). In the "non responders" group(TRG 3, 4 and 5), 37 cases were N+(39.8%) and 56(60.2%) were N0(P < 0.001).CONCLUSION: Response to neoadjuvant chemoradiation in rectal cancer is associated with lymph node involvement.
